Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/20—Hypnotics; Sedatives

Definitions

• sleep disorders such as dysomnia, sleep walking disorders, jet-lag and certain emotionally-, drug- or age-related sleep disturbances, can be alleviated if the patient, or subject, suffering therefrom can be induced to engage in paradoxical or rapid eye movement (REM) sleep for longer periods of time.
• REM rapid eye movement
• REM sleep is believed to be important in the body's overall well being, since it is during periods of REM sleep that much of the damage done to the body as the result of physiological and/or psychological stress is repaired or alleviated.
• Sedative and hypnotic drugs such as the benzodiazepines, are generally contraindicated since they actually decrease REM sleep time, prolong REM latency and produce REM rebound.
• antidepressants have not been selected as agents when the object of treatment is the production of more deep, or REM, sleep and less light sleep.
• Disorders which may be treated according to the invention include a variety of conditions which are usually associated with decreased REM sleep, decreased slow-wave (i.e., state 3 or 4) sleep, or both. Among them are nocturnal myoclonus, REM sleep interruptions, jet-lag, shift workers' sleep disturbances, dysomnias, night terror, sleep walking, insomnias associated with depression and those associated with other emotional/mood disorders.
• certain drugs may also cause reductions in REM sleep as a side effect.
• the process of the invention may be used to correct those types of sleeping disorders as well.
• Formula I is: wherein X is a direct bound, O, N, NH or S; R1 and R3 are each hydrogen or C 1 ⁇ 6 substituted or unsubstituted hydrocarbon groups which may be converted to the ring via an -O- or -N- linkage; R2 and R4 are each a direct bond, a C1 ⁇ 8 saturated or on unsaturated hydrocarbon group; Y is a halogen atom.
• the compound nefazodone a non-sedating antidepressant which has formula II, significantly increased REM sleep in clinical tests conducted in human volunteers. Nefazodone also yielded decreases in REM latency (i.e., the sleeping time before REM phases begin), while maintaining a normal duration of slow-wave sleep.
• Nefazodone is the subject of U.S. 4,338,317, which shows its production and use as an antidepressant. Several of its salts are also disclosed.
• the invention deals with a method for treating sleep disorders via the administration of suitable quantities of compounds of formula I.
• the process of the invention has several advantages over other methods of enhancing or inducing REM sleep in subjects suffering from sleep disorders.
• the compounds of the invention are not sedatives. Thus, they do not cause daytime drowsiness or promote sleepiness or generally lengthen the duration of total sleep time (i.e., the combined time for REM and NREM, or non rapid eye movement, sleep).
• REM sleep which is beneficial in assisting the body in its attempts to alleviate the effects of various stresses, is maximized.
• all known marketed antidepressants have reduced REM, prolonged REM latency and reduced the number of REM episodes which occurs.
• the compounds of the invention are antidepressants, they tend to make the subjects using them feel better during their waking hours.
• the compounds, or drugs, which are the active ingredients in the processes of the invention are compounds of Formula I or their pharmaceutically acceptable derivatives.
• X is a direct bond, O, N, NH or S
• R1 and R3 are each (independently of each other) hydrogen or C1 ⁇ 6 substituted or unsubstituted hydrocarbon groups, -OR5, -NHR5, -C(O)R5 or - C(O)OR5, wherein R5 is a C1 ⁇ 6 hydrocarbon group containing 0 to 2 sites of unsaturation.
• R2 and R4 are each (independently of each other) a direct bond, a C1 ⁇ 8 saturated or unsaturated hydrocarbon group;
• Y is a halogen atom.
• X is -O- or -S-, with -O- most preferred.
• R1 and R3 are C1 ⁇ 6 hydrocarbon groups or substituted C1 ⁇ 6 groups having 0 to 2 sites of unsaturation. While it is preferred that they be hydrocarbon groups and preferably alkyl groups, one or both of R1 and R3 may have up to 3 substituents. In addition, R1 and R3 may contain -O-, -C(O)-C(O)-O- or -N- linkages. Useful substituent groups on R1 and/or R3 are Cl, Br, NO2, NH2, PO4, and the like.
• R1 and/or R3 may also be -OR5, -NHR5, -C(O)R5 or - C(O)OR5, wherein R5 is a substituted or unsubstitued C1 ⁇ 6 hydrocarbon group containing 0 to 2 sites of unsaturation.
• R5 may have up to 3 substituents as defined above.
• R1 and R3 be a H and a C1 ⁇ 3 alkyl group respectively. It is highly preferred that R1 be H and R3 be C2H5.
• R2 and R4 may each be a direct linkage or a C1 ⁇ 8 hydrocarbon group. While the hydrocarbon group may have 1 or 2 sites of unsaturation, it is preferred that it have none, so that R2 and R4 are both saturated. Preferably R2 and R4 are C2 ⁇ 5 alkylene bridges. Most preferably, R2 is C2H4 and R4 is C3H6, both aliphatic. Y may be Cl, Br, Formula I, but is preferably Cl or Br, and most preferably Cl.
• Pharmaceutically acceptable derivatives of compounds of Formula I include salts, esters, and the like.
• Useful salts can be be formed using such acids as hydrochloric, hydrobromic, hydroiodic, citric, acetic, benzoic, stagelic, phosphoric, nitric, mucic, isethionic, palmitic, heptmoic and the likes.
• the compounds of the invention are generally known compounds produced by conventional techniques.
• nefazodone is produced by the procedures described in U.S. patent 4,338,317 .
• the preparation of other derivatives is generally carried out by contacting the base with the acid or other suitable reactant. Such contact is preferably done while the reagents are in solution. Other conventional procedures for preparing derivatives are contemplated.
• the compounds of the invention are to be administered in accordance with the needs of the particular patient and under the supervision of a competent physician. Generally, however, they are used in dosages of about 25 mg/day to about 1,500 mg/day, with administration of about 25 to about 600 mg/day preferred, and 100 to about 400 mg/day highly preferred.
• the drug is generally given 1 to 3 times per day, so that the total daily dosage is within the range set out above.
• the compounds of the invention may be administered via a variety of routes. Intravenous, intramuscular subcutaneous, transnasal, transdermol, ocular and rectal routes are also contemplated.
• the drug(s) When transdermal, ocular or other topical delivery routes are employed, the drug(s) will be formulated into suitable formulations. Those formulations will contain conventional ingredients, eg, fillers, colorants, penetration enhancers, stabilizers, etc. in suitable quantities.
• nefazodone 400 mg was administered orally to twelve (12) individuals.
• a control group of 12 was given a placebo.
• Two other groups of 11 and 12 subjects each, respectively, were given oral 200 mg trazodone and buspirone. Both of these drugs generally are considered sedating antidepressants.
• the nefazodone group experienced an average of 116 minutes of REM or state 5 sleep, compared to 96 minutes of REM sleep for the placebo (in control) group.
• the trazodone and buspirone recipients averaged 67 and 70 minutes of REM sleep.
• phase 3 and 4 sleep values for the nefazodone group decreased slightly from 27 minutes (phase 3) and 28 minutes (phase 4) for the controls to 25 (both phases 3 and 4) for the nefazodone group.
• Light sleep was characterized in the control group by average times of 12 minutes (stage 0), 11 minutes (stage 1) and 267 minutes (stage 2).
• the nefazodone recipients had lower averages for light sleep, i.e., 15 minutes (stage 0), 9 minutes (stage 1) and 235 minutes (stage 2).
• Total sleep time for the nefazodone group was 415 minutes, compared to total sleep times of 424 minute for the placebo group and 409 and 411 minutes total for the trazodone and buspirone groups.
• Nefazodone represents an improvement, in terms of REM sleep, of 173% over trazodone and 165% over buspirone.
• nefazodone group's REM average of 116 minutes was 120% better than the placebo group's 96 minutes.

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• Engineering & Computer Science (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Biomedical Technology (AREA)
• Neurology (AREA)
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• Chemical Kinetics & Catalysis (AREA)
• General Chemical & Material Sciences (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Organic Chemistry (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

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• 1990
  • 1990-12-03 US US07/620,696 patent/US5116852A/en not_active Expired - Lifetime
• 1991
  • 1991-11-07 JP JP3350548A patent/JP3062974B2/ja not_active Expired - Fee Related
  • 1991-11-08 MX MX9101994A patent/MX9101994A/es not_active IP Right Cessation
  • 1991-11-27 CA CA002056201A patent/CA2056201A1/fr not_active Abandoned
  • 1991-11-28 IL IL10018391A patent/IL100183A/en not_active IP Right Cessation
  • 1991-11-29 DK DK91120587.0T patent/DK0493687T3/da active
  • 1991-11-29 AT AT91120587T patent/ATE136777T1/de not_active IP Right Cessation
  • 1991-11-29 DE DE69118859T patent/DE69118859T2/de not_active Expired - Fee Related
  • 1991-11-29 ES ES91120587T patent/ES2087217T3/es not_active Expired - Lifetime
  • 1991-11-29 EP EP91120587A patent/EP0493687B1/fr not_active Expired - Lifetime
• 1996
  • 1996-04-22 GR GR950403454T patent/GR3019692T3/el unknown

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